Resident impact on operative duration for elective general surgical procedures

Published:December 31, 2016DOI:



      Resident involvement in operations increases operative duration. This study investigated resident impact on operative time for a single general surgeon in an outpatient surgical setting.


      A retrospective review was performed of index general surgical operations meeting inclusion criteria. Operative duration, patient demographics, 30-day complication/readmission rates, and degree of resident involvement were collected.


      625 cases were analyzed. Patient demographics were similar for all procedural comparison groups. Operative time increased with resident involvement for each operation—umbilical hernia repairs were associated with a 19% increase (22.3 ± 6.7 versus 26.5 ± 7.5 min, p = 0.002), laparoscopic cholecystectomies demonstrated a 15% increase (25.8 ± 8.7 versus 29.7 ± 10.2 min, p = 0.001), and laparoscopic inguinal hernia repairs demonstrated a 25% increase (32.1 ± 11.3 versus 40.2 ± 8.9 min, p < 0.001).


      Each surgeon must decide if the increase in operative duration caused by resident involvement is justified by the intangible benefits residents provide.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to The American Journal of Surgery
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Hwang C.S.
        • Wichterman
        • Alfrey E.J.
        The cost of resident education.
        J Surg Res. 2010; 163: 18-23
        • Pollei T.R.
        • Barrs D.M.
        • Hinni M.L.
        • et al.
        Operative time and cost of resident surgical experience: effect of instituting and otolaryngology residency program.
        Otolaryngology. 2013; 148: 912-918
        • Calhoon J.H.
        • Baisden C.
        • Holler B.
        • et al.
        Thoracic surgical resident education: a costly endeavor.
        Ann Thorac Surg. 2014 Dec; 98: 2012-2014
        • Hernandez-Irizarry R.
        • Zendejas B.
        • Ali S.M.
        • Lohse C.M.
        • Farley D.R.
        Impact of resident participation on laparoscopic inguinal hernia repairs: are residents slowing us down?.
        J Surg Educ. 2012; 69: 746-752
        • Papandria D.
        • Rhee D.
        • Ortega G.
        • et al.
        Assessing trainee impact on operative time for common general surgical procedures in ACS-NSQIP.
        J Surg Educ. 2012; 69: 149-155
        • Kazaure H.S.
        • Roman S.A.
        • Sosa J.A.
        The resident as surgeon: an analysis of ACS-NSQIP.
        J Surg Res. 2012; 178: 126-132
        • Davis S.S.
        • Husain F.A.
        • Lin E.
        • et al.
        Resident participation in index laparoscopic general surgical cases: impact of the learning environment on surgical outcomes.
        J Am Coll Surg. 2013; 216: 96-104
        • Advani V.
        • Ahad S.
        • Gonczy C.
        • et al.
        Does resident involvement effect surgical times and complication rates during laparoscopic appendectomy for uncomplicated appendicitis? An analysis of 16,849 cases from the ACS-NSQIP.
        Am J Surg. 2012; 203: 347-351
        • Allen R.W.
        • Pruitt M.
        • Taaffe K.M.
        Effect of resident involvement on operative time and operating room staffing costs.
        J Surg Educ. 2016 Nov–Dec; 73 (Epub 2016 Jun 24): 979-985